■这项研究的目的是调查骨量减少,骨减少症,肝胆胰癌(HBPC)患者的术后结局。
■三个在线数据库,包括Embase,PubMed,还有Cochrane图书馆,彻底搜索了描述骨量减少之间关系的文献,骨减少症,从每个数据库开始到2023年9月29日,HBPC患者的手术治疗结果。纽卡斯尔-渥太华量表用于评估研究质量。
■该分析包括总共16篇文章和2,599名个体的合并患者队列。结果表明,与没有骨量减少的患者相比,HBPC患者的OS(HR:2.27,95%CI:1.70-3.03,p<0.001)和RFS(HR:1.96,95%CI:1.42-2.71,p<0.001)明显较差。亚组分析表明,这些发现在单变量和多变量分析中是一致的,以及肝细胞癌,胆道癌,还有胰腺癌.与没有骨量减少的患者相比,骨量减少的患者发生术后主要并发症的风险明显更高(OR:1.66,95%CI:1.19-2.33,p<0.001)。此外,我们还发现,与没有骨肉瘤减少症的患者相比,HBPC患者中存在骨肉瘤减少症与较差的OS(HR:3.31,95%CI:2.00-5.48,p<0.001)和PFS(HR:2.50,95%CI:1.62-3.84,p<0.001)显著相关.
■术前骨量减少和骨量减少可预测术后HBPC的OS和RFS较差。
UNASSIGNED: The purpose of this study is to investigate potential associations between
osteopenia, osteosarcopenia, and postoperative outcomes in patients with hepatobiliary-pancreatic cancer (HBPC).
UNASSIGNED: Three online databases, including Embase, PubMed, and the Cochrane Library, were thoroughly searched for literature describing the relationship between
osteopenia, osteosarcopenia, and outcomes of surgical treatment of HBPC patients from the start of each database to September 29, 2023. The Newcastle-Ottawa Scale was used to rate the quality of the studies.
UNASSIGNED: This analysis included a total of 16 articles with a combined patient cohort of 2,599 individuals. The results demonstrated that HBPC patients with
osteopenia had significantly inferior OS (HR: 2.27, 95% CI: 1.70-3.03, p < 0.001) and RFS (HR: 1.96, 95% CI: 1.42-2.71, p < 0.001) compared to those without osteopenia. Subgroup analysis demonstrated that these findings were consistent across univariate and multivariate analyses, as well as hepatocellular carcinoma, biliary tract cancer, and pancreatic cancer. The risk of postoperative major complications was significantly higher in patients with osteopenia compared to those without
osteopenia (OR: 1.66, 95% CI: 1.19-2.33, p < 0.001). Besides, we also found that the presence of osteosarcopenia in HBPC patients was significantly related to poorer OS (HR: 3.31, 95% CI: 2.00-5.48, p < 0.001) and PFS (HR: 2.50, 95% CI: 1.62-3.84, p < 0.001) in comparison to those without osteosarcopenia.
UNASSIGNED: Preoperative
osteopenia and osteosarcopenia can predict poorer OS and RFS with HBPC after surgery.